Baby Pacifier Pros and Cons

Do babies need pacifiers?
baby with pacifier held by daddy

Pacifiers are hardly a new invention. “Archeologists have found pacifier-type objects made of silver, clay and even pearl, dating back thousands of years,” says pediatrician W. Kyle Mudd, DO.

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Despite their ancient history, pacifiers still manage to stir up debate. Should you happily pop one in your baby’s mouth or steer clear? Dr. Mudd weighs the pacifier pros and cons.

What is a pacifier?

Paci, binky, bo-bo or soothie: Pacifiers go by lots (and lots) of nicknames. Whatever you call them, it’s easy to see why so many parents swear by them. The nipple substitute soothes irritable babies by satisfying their natural need to suck. “It can be very helpful when an infant is fussing,” Dr. Mudd says.

A calm, quiet baby may be reason enough to hop aboard the binky train. But there’s another big benefit. “Numerous studies have shown that pacifiers reduce the risk of sudden infant death syndrome (SIDS), especially during the first six months of life,” Dr. Mudd says. SIDS, also known as crib death, is the sudden and unexplained death of a baby during the first year of life.

Are pacifiers bad?

While pacifiers have some big benefits, there are some downsides. And since many babies often fall in love with theirs right away, it’s worth considering the pitfalls before you introduce them.

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  • Nipple confusion: “If a baby has a pacifier too early, it can disrupt their ability to learn to latch on to the breast to breastfeed,” Dr. Mudd says. “To avoid this ‘nipple confusion,’ I recommend avoiding pacifiers for the first two to four weeks after a baby is born. Once breastfeeding is well established, it’s fine to use a pacifier.” 
  • Pacifier reliance: If your little one is used to falling asleep with a paci, they’ll soon need that paci to get back to sleep if they wake during the night. “Parents often have to get up multiple times a night to search for a dropped pacifier,” Dr. Mudd says. “Consider leaving multiple pacifiers in the crib at night so you (and eventually, your baby) can easily grab another.”
  • Ear problems: Researchers have found that in babies 6 to 12 months old, using pacifiers increases the risk of fluid buildup in the ears. That can increase the risk of ear infections. “It’s not a huge risk, but it does happen,” Dr. Mudd says. Talk to your doctor if your baby is getting ear infections. You may need to bid the binky goodbye.
  • Dental problems: Sucking on a pacifier (or a thumb) can cause a child’s teeth to be misaligned. “It’s a valid concern, but not until the child is between 2 and 4 years old,” Dr. Mudd says. To avoid dental drama, try to wean kiddos off the pacifier by their fourth birthday.

When to introduce a newborn pacifier

Babies are born to suck, and they can usually start using pacifiers right away. Dr. Mudd notes that pacifiers are often given to premature babies to help them develop the reflexes to suck and swallow.

If you’re breastfeeding, it helps to avoid using a pacifier for the first two to four weeks until your baby has feeding figured out. If you’re bottle-feeding, however, there’s no reason to wait.

Pacifiers are safe to use day and night, even when the baby is sleeping. But avoid using the binky to soothe a hungry baby. “Pacifiers shouldn’t be used to replace or delay meals, so we recommend offering them only when the baby isn’t hungry,” Dr. Mudd says.  

My baby won’t take a pacifier

You were counting on using pacifiers. But your wee one isn’t interested. Should you be worried? “Try not to overthink it,” Dr. Mudd says.

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While pacifiers can be one tool for decreasing the risk of SIDS, they aren’t the most important. “The most important thing is to practice safe sleep,” Dr. Mudd says. Lie your baby down on their back, on a firm mattress, with no blankets or stuffed animals in the crib. “As long as you’re practicing safe sleep, I wouldn’t be concerned about a baby not wanting a pacifier.” 

Pacifier safety: What’s the best pacifier?

The pacifier aisle is almost as overwhelming as the cereal aisle with so many shapes, sizes and colors.

What should you look for in a binky? Dr. Mudd offers these tips for pacifier safety:

  • Shape: Pacifiers typically have a nipple made of silicone or rubber connected to a larger piece, called the shield. Dr. Mudd recommends looking for a paci that’s all one piece. “If the nipple and the shield are two separate pieces, there’s a chance they could come apart and pose a choking hazard,” he says.
  • Size: Make sure the pacifier shield is large enough so that the baby can’t put the entire thing in their mouth.
  • Clean: Look for a pacifier that’s dishwasher-safe for easy cleaning. “Run it through the dishwasher or boil it before the first use,” he says. “After you wash it, make sure to squeeze out any hot water before you give it to the baby.”
  • Replace: If the rubber nipple starts to look rough or worn, it’s time to chuck the pacifier and get a new one.

And if you do go the pacifier route, do yourself a favor and stock up, Dr. Mudd says. “It’s always good to have extras on hand. No matter how careful you are, they will be dropped and lost.”

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